Biomedical subjects

K S Yin

Publications and source records attributed to K S Yin.

10 recordsLinked to original sources

PubMed2001

Factors associated with sleep apnea in men with spinal cord injury: a population-based case-control study.

OBJECTIVE: To characterize a population of spinal cord injury (SCI) patients with sleep apnea, and to determine associated factors and comorbidities. STUDY DESIGN: Population-based retrospective case-control study. SUBJECTS: 584 male patients served by a Veterans Affairs SCI service. MEASURES: Medical records were reviewed for sleep apnea diagnosis, demographic information, neurologic characteristics, and treatments received. Sleep study reports were not available to determine the nature of abnormal respiratory events (ie central, obstructive, hypoventilation). For each case with tetraplegia, a control tetraplegic subject without sleep apnea diagnosis was selected. RESULTS: We identified 53 subjects with diagnosed sleep apnea: 42 tetraplegic, 11 paraplegic. This represented 14.9% of all tetraplegic and 3.7% of all paraplegic patients in the population (P<0.0001 for comparison of tetraplegic and paraplegic proportions). In tetraplegic subjects, sleep apnea was associated with obesity and more rostral motor level, but not with ASIA Impairment Scale. Medical comorbidities associated with sleep apnea in non-SCI patients, such as hypertension, were more common in case subjects. Less than half of case subjects were receiving some form of treatment. For motor-complete tetraplegics, long-term positive airway pressure treatment was less common with motor level C5 and above compared to C6 and below. CONCLUSION: In this population, sleep apnea has been frequently diagnosed, particularly in tetraplegic subjects. The true prevalence is likely to be considerably higher, since this study considered only previously diagnosed cases. Sleep apnea was associated with obesity and higher neurologic level, but not ASIA Impairment Scale. Medical comorbidities were more frequent in this group, and treatment acceptance was poor with higher level motor-complete injuries. Since the type of sleep apnea (central or obstructive) was not distinguished, we cannot comment on the prevalence and associations based on specific types of sleep apnea.

Adult↗

PubMed2001

Refractory heterotopic ossification with complications.

BACKGROUND: Heterotopic ossification (HO) following spinal cord injury can lead to various complications, including venous thrombosis, autonomic dysreflexia, and pressure ulcers. We report refractory, complicated HO in a 19-year-old man with C8 incomplete tetraplegia. He first presented at 9 weeks postinjury with fever and swelling of his right leg. Ultrasound indicated a deep venous thrombosis (DVT). Persistent symptoms prompted triple-phase bone scan and magnetic resonance imaging (MRI), which revealed HO compressing the right external iliac vein and no evidence of DVT. The HO was complicated by hypercoagulability. CLINICAL COURSE: The HO was refractory to oral indomethacin and etidronate; therefore, intravenous etidronate was instituted, resulting in only a transient decrease in alkaline phosphatase. Local irradiation of the right hip did not decrease the activity of HO. The patient was discharged on oral etidronate, indomethacin, and warfarin. This complicated case raises issues regarding early diagnosis and aggressive treatment of HO, as well as treatment of associated hypercoagulability.

Constriction, Pathologic↗

PubMed1998

Myelopathy secondary to spinal epidural abscess: case reports and a review.

Spinal epidural abscess (SEA) is a rare disease with an unknown incidence rate. This paper will illustrate that early diagnosis and rehabilitation may result in improved outcomes for patients with neck or back pain presenting with neurological deficits. Three cases of SEA in individuals without the commonly acknowledged risk factors of intravenous drug abuse (IVDA), invasive procedures, or immunosuppression were seen at our institution during a 10-month period between October 1995 and July 1996. The patients presented with neck or thoracic back pain and progressive neurological deficits without a febrile illness. Predisposing factors were thought to be urinary tract infection with underlying untreated diabetes mellitus in the first case, a history of recurrent skin infection in the second, and alcoholism without a definite source of infection in the third. Leukocytosis, elevated sedimentation rate, and confirmatory findings reported on magnetic resonance imaging (MRI) led to the diagnosis of SEA in all three cases. Immediate surgical drainage and decompression followed by proper antibiotic treatment and early aggressive rehabilitation led to good functional outcomes. All the individuals became independent in activities of daily living, wheelchair mobility, and bowel and bladder management. Two eventually became ambulatory.

Abscess↗

PubMed1991

[The effect of azelastine on the down-regulation of beta-adrenoceptors].

The effect of azelastine, a new on the down-regulation of beta-receptor agonist was investigated. Male Hartley guinea pigs received injections of saline or terbutaline (T.) and/or azelastine (A.) for successive 7 days. The radioligand binding assays for beta-adrenoceptors in the lung membranes of the guinea pigs were performed. The results showed the differences of numbers of maximal binding sites (Bmax) among four groups were significant. The Bmax of beta-adrenoceptor in T. group was less than that in control group (P less than 0.02). The Bmax in A. group was more than that in control group (P less than 0.05). The Bmax in T. plus A. was more than that in T. group, and there was no significant difference between Bmax in T. group and in T. plus A. group (P greater than 0.1). The differences of affinity (Kd) of beta-adrenoceptor among four groups were not significant. Azelastine increased the density of beta-adrenoceptors and partially prevented the down-regulation of beta-adrenoceptor caused by terbutaline.

Animals↗

PubMed1991

Effect of azelastine on the down regulation of beta-adrenoceptors in guinea pig lung.

The new antiallergic drug azelastine (E-0659, Azeptin; CAS 58581-89-8) is used in the treatment of rhinitis and bronchial asthma. In the present study, the effect of azelastine on the regulation of the beta-adrenoceptors and the down regulation of beta-adrenoceptors by terbutaline, a beta-agonist, was investigated using guinea pig lungs. Guinea pigs were divided into four groups; (1) the control (saline-treated) group, (2) the terbutaline-treated group, (3) the azelastine-treated group, (4) terbutaline plus azelastine-treated group. Guinea pigs intramuscularly injected with each agent three times a day for successive 7 days. In the terbutaline-treated group, a 26% reduction in the number of beta-adrenoceptors compared with those of the control group was observed. In the azelastine-treated group, the number of beta-adrenoceptors increased by 24% compared with those of the control group. The number of the beta-adrenoceptors in the terbutaline plus azelastine-treated group was significantly increased compared with that of the terbutaline-treated group. These results suggest that azelastine may prevent the down regulation observed during beta-agonist administration by increasing the number of beta-adrenoceptors.

Animals↗

PubMed1984